Program Goals/Target Population
Families Facing the Future (previously called Focus on Families) is an intensive family program for parents in methadone treatment and their children. It combines relapse prevention and parenting skills training with home-based case management services. Its goal is to address risk factors for relapse in addicts and risk and protective factors for future drug abuse and problem behaviors by their children.
The program is based on the Social Development Model (Catalano and Hawkins 1996), which organizes empirical information on risk and protective factors into a development theory of antisocial behavior. Families Facing the Future specifically
addresses risk factors related to relapse among opiate addicts as well as risk
and protective factors associated with drug use among their children.
The parenting skill training consists of 53 hours of training in small groups of 6 to 10 families. There is an initial 5-hour family retreat, with parents and children attending, and 32 ninety-minute meetings twice a week. Children attend 12 sessions so parents can practice skills while their children are supervised. Trainers with master’s-level experience lead the meetings and follow a curriculum created for the program. The curriculum incorporates motivation, discussion, modeling, guided practice, independent practice, and generalization. Parents are trained on skills such as:
- Relapse prevention and coping
- Anger management
- Child development and communication skills
- Holding family meetings
- Setting clear expectations of children
- Use of appropriate rewards and disciplinary consequences
The complete home-based case management component lasts about 9 months. It begins 1 month before the start of the parent training sessions and continues while parents are participating in the training meetings and for 4 months afterward. Visits are about 90 minutes once a week, plus two phone calls each week. With case managers’ assistance, families set goals, monitor progress toward the goals, and reinforce skills learned in the parent training meetings. Case managers help families hold family meetings, increase opportunities for positive family involvement, and promote opportunities for positive activities for children outside of the family.
8 to 12
Although studies evaluating the effectiveness of Families Facing the Future on the behaviors of drug-using parents and their children showed some positive findings, the overall preponderance of evidence suggested null effects.
Parent Problem-Solving Skills
Catalano and colleagues (1999) found no significant differences between groups on problem-solving skills at the 6-month follow-up. That changed at the 12-month follow-up, where treatment participants showed significantly better problem-solving skills—specifically for drug-related role-play situations—than participants in the control group. No significant difference was found for nondrug-related role-play situations.
Parent-Reported Family Cohesion
There were no significant differences in family bonding or conflict at the 6-month follow-up. At the 12-month follow-up, however, treatment participants reported significantly less domestic conflict and scored significantly higher on the nine-item scale of household rules.
Parent Drug Use
No significant differences were found for drug use (including marijuana, cocaine, and heroin) at the 6-month follow-up. Participants reported significantly less heroin use at the 12-month follow-up but there were no significant differences found for marijuana and cocaine.
Analysis on prevalence of drug use (including marijuana, cocaine, and heroin) was not significant at the 6-month follow-up. At 12 months, treatment participants were less likely to be using cocaine compared with control participants but there were no significant differences found for prevalence of marijuana and heroin use.
Child Problem Behaviors
There were no significant differences found for problem behaviors, negative peer networks, and delinquency.
Child Family Involvement
There was an age-by-group assignment interaction at the 6-month follow-up, showing that older children in the treatment group engaged in significantly fewer activities with their parents, while younger children in the same group engaged in significantly more activities with their parents.
Child Drug Use
No significant differences were found for child drug use, although the direction of differences favored the treatment group.
Reduced Drug Use
Haggerty and colleagues (2008) found no significant difference between treatment and control groups on any substance use, nor for alcohol, marijuana, cocaine, amphetamines, and opiates when analyzed separately.
Age Interaction on Reduced Drug Use
There were no significant interactions by age on occurrence of substance use disorders.
Gender Interaction on Reduced Drug Use
Looking at the entire sample, male study participants were three times as likely to develop an alcohol use disorder and twice as likely to develop a marijuana use disorder, compared with female participants. Males in the treatment group were at significantly less risk for any substance use disorder, compared with the male control participants. Female treatment participants had indicated a higher risk of substance use disorders, but the result was not significant. Treatment males were significantly less likely than control group males to develop alcohol and marijuana disorders. Treatment females had a higher likelihood of developing a substance use disorder; however, this was not significant.
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